Monday, January 29, 2007

Adriana's birth story: Laboring at home

As brevity is apparently not my strong suit, I'll be posting this in several pieces.

On January 9th, I went for my 41-week appointment with the midwife. We had a non-stress test, where the midwife, Regina, strapped an external fetal monitor around my belly. That tracked the baby's heart rate on a strip of paper, and I pressed a button every time I felt the baby move, which made a made a mark on the paper to show whether the baby's heart rate increased in response to movements. After about 20 minutes, we could see that the baby was indeed "reactive" and doing fine, but I got a referral for an ultrasound on Friday to check to make sure I still had adequate amniotic fluid. During the test we talked about inducing labor. The practice would only allow me to go two weeks past my due date before referring me to their back-up physician for induction and a hospital birth.

I didn't want a hospital birth, but I had spent the day before thinking a lot about the possibility. I knew that when I went through the doors of the hospital to give birth, I was putting myself at higher risk for interventions that I didn't want--Pitocin, episiotomy, c-section. Those interventions wouldn't be the end of the world, I knew, but I hated the idea of giving up our plans for a peaceful birth at the center with few or no interventions. I talked with a friend about my worries, and she pointed out that just because I was more likely to face those things in a hospital setting, I wasn't necessarily going to experience them, as I had educated myself and was making an effort not to have to go through them. Somehow, those words helped. I went to yoga that night to help me relax and by the time of my visit I was feeling better. I hadn't exactly come to terms with the idea of a hospital induction, but I felt calmer about it.

We looked at the calendar with Regina and decided that the induction would probably have to be scheduled for the 15th or 16th, depending on whether the hospital would do a scheduled induction on the Monday holiday. I crossed my fingers that I would have until at least the 16th, and Regina said she would talk with the other midwives about letting me go that long--42 weeks and 2 days--but that she thought it would be fine. I could tell she didn't like the idea of the hospital induction either. We discussed more "natural" methods of induction as well, such as castor oil, evening primrose oil, and "stretch and sweep." Regina offered to do the stretch and sweep during that office visit, and I agreed. I didn't think it would actually work, but I figured it was worth a try. Regina said that it seemed most effective when done repeatedly, so I could come back in Friday after my ultrasound for a second try.

I expected the S&S to hurt, but it wasn't too bad. It was difficult at first for Regina to reach my cervix. The baby's head was low, and my cervix was still back behind it. I was about 50% effaced, and when Regina said that laughed to myself. At my 36-week visit, I had been 50% effaced, and Brian and I had become certain that meant the baby wouldn't be late after all. Regina also said I was only one centimeter dilated, but that was enough. She used a finger to pull the edge of the cervix back and try to separate the bag of waters from the cervix. I felt a bit of cramping in my low back, but not the kind of pain I had expected.

We headed home, stopping at Whole Foods on the way for a bottle of evening primrose oil capsules and some Ben & Jerry's. (What? Cookie dough ice cream totally helps induce labor. I'm sure I read that somewhere.) After dinner, I took two capsules and ate some ice cream. The cramping I had felt during the exam was mild, feeling mostly like PMS, but I had felt that way a lot over the past couple of weeks. By the time we went to bed around 11 that night, the feeling was getting stronger. I lay in bed trying to sleep as the cramping came and went. Eventually I felt a wave of nausea and got up to be sick.

I spent the next few hours back and forth between bed and the bathroom. I went downstairs and got out a bottle of the sports drink I had bought to take to the birth center for during labor. Water tasted funny and I thought I would have a better chance of keeping that down than actual fruit juice. I drank a few ounces and went back to bed, but soon needed to throw up again. I finally woke up Brian to tell him that I was sick. He got up with me for a little while and sat in the bathroom with me while I tried to throw up. We went back to bed so we could try to sleep, but my cramps kept coming. I started to wonder if this was labor, but the pain was all in my low back. Nevertheless, I started looking at the clock: five minutes between, then 30, then twelve. There was no regularity. Brian slept, and when I had a 30-minute break, I think I was able to doze too. When the cramps were particularly strong I would wake Brian and he would press on my back while I took long, slow, deep breaths.

Around four o'clock, I started to think about calling a midwife. I wondered who was on call; we had forgotten to pick up the January call schedule. Not that it mattered--I like all the midwives, and if I needed someone, it wasn't as though I had a choice of who I got. At 4:45, after getting sick one more time, I woke Brian and told him I was going to call.

When the answering service picked up, I said that I needed to speak with a midwife. "Are you in labor?" the woman asked. I told her that I didn't know. I was starting to think that I might be, but I still hadn't felt any pain in my belly, just the normal tightening of Braxton-Hicks contractions that I had been feeling for several weeks. Within 15 minutes, one of the midwives, Marsha, returned my call. I described what was going on. She asked whether my belly was tightening and whether there was any regularity to the cramps or the Braxton-Hicks contractions. I told her there wasn't, but she told me that it could still be labor. She wanted me to try to drink a little something and get some rest. I hung up the phone and went back to what I'd spent the rest of the night doing.

I did manage to get some sleep here and there. Brian applied pressure to my back and kept encouraging me to eat or drink something. The sun came up, and I know Brian was on the phone with Marsha again at some point, while I rested in bed, breathing through what I still thought were cramps, although Brian and Marsha had decided it was labor. At one point I decided a hot shower would help me relax. I was having trouble standing and breathing when the cramps would hit, so I pulled a towel into the shower and knelt on it, letting the hot water hit my low back. Finally, I found some relief.

While I was in the shower, Marsha suggested to Brian that we come into the birth center. She could give me some Ambien to help me rest up so that I would have energy for labor. But after my shower I was able to relax and doze a bit more, so we decided to stay at home. We called our birth assistant, Pam, to tell her what was going on. Brian described everything to her, and then I spoke to her, telling her that I didn't really think I was in labor, as the pain was all in my back. She suggested getting onto my hands and knees to try to ease the pain of the cramps, and to lean over pillows in that position to get some rest in between. I did what I could to relax, and eased myself through contractions with deep breaths, beginning to vocalize with low moans when I exhaled.

Finally, conceding that this might be labor and that I was too uncomfortable to stay home any longer, I told Brian to call Marsha and tell her we would be coming in. Brian began throwing the last minute items into our bags, and to move things to the car, while I breathed through contractions on my own the best I could.

I hadn't realized how much being calm and breathing carefully helped manage the pain until one hit me really hard. I didn't realize that Brian had taken a bag out to the car, and I called out for him. When he didn't respond I called again and began to panic. The pain grew worse and my breathing became more erratic. I called for him over and over until he was there, apologizing, trying to calm me down. "Where are you? Why didn't you come?" I asked him, when the pain finally subsided. He explained, and then began timing his trips outside so that he was always back for contractions, sprinting to the car with my duffel bag, returning to help me with a contraction, then sprinting back out to put my exercise ball in the back of the car. At last he helped me out to the car and we were on our way.


Jennifer said...

gripping! can't wait to read more... hope newmomhood is treating you three well.

jfh said...

Wow, sandblower, this is exciting. Was Adriana born in the car? Enquiring minds want to know.